COVID-19 is forcing our healthcare system to make impossible choices, but these decisions are necessary because the best way to keep patients comfortable right now is to keep them safe.
There are countless stories. New mothers showing symptoms of coronavirus are being separated from their newborns right after giving birth. Doctors in hard-hit hotspots like New York and New Jersey are notifying families by phone that their loved one passed away because most visitors are no longer allowed inside hospitals.
And in one instance, an 87-year-old great grandmother who later died from coronavirus in a Kentucky hospital was able to speak face to face with one of her children only because the facility had a hazmat-like suit available. Her other children had to say goodbye over FaceTime from the facility parking lot — while standing six feet apart.
These tragic examples are the new norm necessitated by COVID-19. They also reveal an old truth: patient experience and safety are linked, particularly when a highly contagious and deadly disease is wreaking havoc on a large population. We know distancing is the best way to slow the spread of COVID-19, so difficult as it may be to deny a mother the opportunity to hold her baby, or to allow a family to say goodbye face to face, sometimes healthcare professionals have to make those calls to save lives.
We recently celebrated Patient Experience Week, a time to recognize healthcare professionals who improve patient outcomes by really listening to their patients and addressing their needs. Normally this would have been an opportunity to highlight success stories from health systems like the Cleveland Clinic, which improved patient safety by giving providers more time to do their most critical work after an analysis revealed that 90 percent of its nurses devoted a portion of their time to non-clinical tasks, such as addressing problems with cafeteria food or putting in work orders to clean bathrooms. But this year, the focus was on the practical measures hospitals can take to keep patients safe when they have no choice but to seek care during a pandemic.
For the patients who don’t have COVID, they can be kept safe by reorganizing the flow of healthcare facilities. Most facilities focus on triage and throughput as standard metrics, but now organizations are looking at reverse triage by identifying which patients and practices in the hospital can be moved to other locations. For example, obstetrics can be relocated to surgery centers where they have access to operating rooms for c-sections as well as all of the appropriate care items, allowing those patients to remain isolated.
Patient experience is also changing as hospitals are forced to reallocate staff during COVID-19. In fact, some organizations are limiting the number of staff in rooms as part of an effort to reduce patient exposure to healthcare workers who are at high risk for contracting COVID-19, as well as to accommodate a surge in patients and conserve personal protective gear. The result, of course, is that patients may have fewer opportunities to communicate with staff and have certain needs addressed, but ultimately this reduced-staff strategy meets the most important goal of improving patient safety across a health system.
In my 25 years as an emergency department and intensive care unit nurse, I worked to improve patient safety by addressing patient experience. And I found that the best way to do that is by involving patients in the safety conversation whenever possible. If we don’t, it’s really hard to know exactly what they need. Seeing hospitals make certain procedural changes that can impact patient experience during COVID-19 is painful, but we must recognize that in this extraordinary time the best way to keep patients comfortable is by keeping them safe.
Inge Garrison, R.N., is a former emergency department and intensive care unit nurse and is the Chief Clinical Officer of Verge Health.